Published ahead of print on December 30, 2005, doi:10.1164/rccm.200510-1681OC Am. J. Respir. Crit. Care Med., Volume 173, Number 6, March 2006, 639-643 A more recent version of this article appeared on March 15, 2006
Submitted on October 28, 2005 Detection of Respiratory Syncytial Virus in Adults with Chronic Obstructive Pulmonary DiseaseAnn R Falsey1*,1 Department of Medicine, Rochester General Hospital, Rochester, NY, USA; University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA, 2 Department of Medicine, Rochester General Hospital, Rochester, NY, USA, 3 Department of Pediatrics and Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA * To whom correspondence should be addressed. E-mail: ann.falsey{at}viahealth.org.
Rationale: Recently, respiratory syncytial virus (RSV) RNA has been identified by reverse polymerase-chain reaction (RT-PCR) from a high percentage of stable chronic obstructive pulmonary disease (COPD) patients. These data raise the possibility of persistent low grade infection in this population which could have implications in COPD pathogenesis.
Objectives: RSV persistence was investigated by testing respiratory secretions from COPD patients during illness and at regular intervals over one year.
Methods: Nasal and sputum samples from COPD patients were tested by one tube, nested RT-PCR for RSV every 2 months and during respiratory illnesses for 1 year. Subjects positive for RSV were evaluated weekly until negative in 2 consecutive samples. Nasal secretions and serum were tested for RSV antibody. A Key words: Viral Infection, COPD Exacerbation, Persistent Infection
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4-fold rise was defined as evidence of RSV infection.
Results: 112 persons were enrolled and 92 illnesses were evaluated. RSV was detected by RT-PCR in 6/92 (6.5%) illness vs. 0/685 routine nasal samples and in 5/69 (7.2%) illness vs. 3/315 (0.9%) routine sputums. Four additional RSV infections were identified by serum antibody responses. Eighty percent of RSV infections were associated with serum and/or nasal antibody responses and 73% had symptoms of acute respiratory illness.
Conclusions: Most RSV infections in COPD patients are associated with symptomatic respiratory illnesses and measurable immune responses. Our data does not support the concept of RSV persistence in this population.
